Women and Newborn Health Service

Health A – Z

King Edward Memorial Hospital

Midwifery Labour and Birth FAQ

10. What is the Role of Pain in Labour and Birth?

Midwives believe that the pain of normal labour plays an
important role in the physiology of the birth process. Pain
allows us to accurately assess the progress of labour.

For more information about your pharmocological and non-pharmocological
pain management options, please talk to you midwife or doctor.

11. What can I expect from my Midwife During the Labour and Birth?

Please refer to the Midwifery
Roles in the Labour and Birth Suite for more details.

12. What Care Can I expect During Labour and Birth?

Every woman is a unique individual who will experience
labour and birth differently. Care will be tailored to your
individual needs and preferences. You can expect your labour
to be regularly assessed in the following ways:

your blood pressure, pulse and temperature will be
taken

your abdomen will be felt to determine what position
the baby is in

you will be encouraged to regularly go to the toilet
to empty your bladder (a full bladder stops the head from
coming down)

you will be encouraged to keep well nourished and rested

you may be encouraged to stay active

the baby’s heart rate will be frequently monitored

you may have an internal examination

You are in charge of your own labour and birth. Always
discuss your concerns with your midwife so any necessary
decisions are based on accurate information.

13. What are the Best Positions to be in During Labour and Birth?

It is usually best to maintain an upright position and
be mobile and active during labour. An active labour helps
the baby to maintain or turn into the optimal anterior position.
An upright position will also encourage effective uterine
contractions, shorten the latent phase of labour and reduce
the need for analgesia.
It is best to discuss with your midwife the positions for
labour that will be beneficial to you.

Studies comparing
an upright position with a semi-lying position have shown
that giving birth in an upright position was associated
with:

a shorter second stage of labour

a decreased need for instrumental births

a slight increase in blood loss

more second degree tears

As labour progresses women will try a variety of different
positions. The most important thing is to remain open to
the idea of ‘moving around’, whether this be
standing, walking, in the shower, bath, on the bed, or over
a bean bag on the floor.

14. What are the Stages of Labour?

Every woman experiences labour differently. The stages
of labour are:

Stage 1 - from the onset of regular contractions until
the cervix is fully open (10cm). It is the contractions
of the uterus that thin and open the cervix.
Stage 2 - from full dilatation of the cervix until the baby
is born
Stage 3 - from the birth of the baby until the delivery
of the placenta and membranes
Stage 4 - from the delivery of the placenta through to early
postnatal care

It is not always easy for women to know when labour has
started. Contractions will gradually (or maybe quickly)
get closer together, get stronger and last longer.

It is important to contact your midwife or health care
provider to discuss when to come to hospital or any concerns
you may have.

15. How can I tell where my Labour is up to?

The best methods for determining the status of labour are:

Contractions:
As labour progresses the intensity of the contractions
change. Contractions strengthen and become longer and
closer together.

Maternal behaviour:
Labouring women act in different ways as their labour
progresses. Midwives closely observe a woman in her labour
and can see changes in behaviour which may indicate the
different stages of labour.

Abdominal palpation:
As the labour progresses, the baby’s head will move
further down into your pelvis. Your midwife will monitor
this progression by feeling your abdomen.

Vaginal examination:
Assessing the dilation of your cervix will give the midwife
an idea of where your labour is up to.

16. Can Tearing of the Perineum be prevented
during Childbirth?

Your midwife will work with you to help you birth your
baby with as little intervention as possible. One of the
best ways to help the perineum (skin between vagina and
anus) stretch is to birth your baby slowly. Your midwife
will often do this best by using her voice to guide you.
Sometimes watching the birth of your baby in a mirror helps
you to be in control.

Tearing of the perineum may occur during birth. The following
are some of the techniques midwives may recommend to help
the perineum stretch.

Massaging the perineum:
This can be done during pregnancy or during the 2nd stage
of labour. It involves applying and massaging oils into
the perineum. Studies of perineal massage however showed
no difference in the overall risk of perineal trauma.

Perineal Guarding:
This involves the midwife applying gentle pressure to
your perineum during a contraction. This is usually performed
in conjunction with pressure applied to the baby’s
head to prevent it from coming out too quickly.

Birthing Positions:
Studies have shown that lying on your left side will reduce
the risk of perineal tearing.

17. Do all Tears need Stitching?

The extent or degree of a tear is most often defined on
a scale from 1-4.

Labial tears and first degree tears may not need stitching
(suturing).

Second degree tears will usually be sutured. Many midwives
are trained to suture second degree tears.

Third and fourth degree tears should always be sutured
by an experienced clinician.

On occasion there is a need to cut the perineum to facilitate
the birth of the baby. This is called an episiotomy and
will need to be sutured by your midwife or doctor.